Risk Factors for Falls in Community-Dwelling Older Adults: An Umbrella Review.
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OBJECTIVES: Falls are a key public health concern, resulting in disability and increased mortality risk. An extensive body of literature has examined risk factors for falls; however, results vary across different studies and populations. We aimed to synthesize systematic reviews of fall risk factors in community-dwelling older adults. DESIGN: A systematic review of systematic reviews. Searches were executed in 6 databases (MEDLINE, Embase, CINAHL, Cochrane Library, PsychINFO, and AgeLine) from inception until June 13, 2023. SETTING AND PARTICIPANTS: Eligible studies included systematic reviews of prospective cohort studies that included a population of community-dwelling older adults (≥60 years of age) and reported fall risk factors. METHODS: Three reviewers screened 8173 records. Summary data were extracted, and the units of analyses were the relationships between risk factors and falls. Descriptive results are reported in counts and frequencies. RESULTS: Fifty-seven reviews were included examining 29 risk factors. Mobility-related measures (balance, gait, physical function, physical activity, dual task ability, strength, and range of motion) accounted for 40% of all relationships. Clinical tests of balance and physical function, cognition, specifically executive function (76% significant) and processing speed (100%), medications (58%), frailty (100%), and chronic conditions (83%) were all consistent predictors of falls. There was a paucity of evidence for psychosocial, environmental, and sociodemographic factors. Most reviews (54%) were rated as low risk of bias. CONCLUSIONS AND IMPLICATIONS: Mobility-related risk factors for falls are well established and can be addressed through interventions. Findings highlight the limited examination of psychosocial, sociodemographic, and environmental risk factors for falls, indicating areas for future research.
